Buying a pair of hearing aids can be like shopping for a new pair of expensive designer shoes: you’ve got to get exactly the right fit; they have to be sturdy and comfortable enough to wear all day; but you want them to look really good as well. It’s not an easy combination, especially the part about looking good. In 1998 I got my first pair of the completely-in-the canal (CIC) Senso hearing aids from Widex. I realize now I put fashion higher on the list over function than I should have at the time. They sure looked good — the pioneering Senso product would go on to win international consumer-product design awards — and they were invisible in my ear. But I always had feedback problems with them, and while they stayed snugly in my ear, they weren’t exactly what I would call comfortable, especially at the end of a 16-hour day. It was just like the Italian-suit phase I went through in the early ’80s, when people still dressed up for business. Boy did I look terrific, and they made me feel like a million bucks…. except for the shoes.
The expensive Ferragmo wingtips I bought with my Italian suit were small, light, sleek and very cool to look at. They made you feel like a combination of Fred Astaire and Al Pacino as the young Michael Corleone. The only problem was that they hurt. Then, after weeks of jamming my feet into them day after day, one of my toenails started to turn black. I decided I simply didn’t have high-fashion feet. Don’t get me wrong, I love my feet. They are only average length, somewhat wide, maybe even a little brick-shaped, but they are terrific for everything I need them for — I use them for all kinds of sports, for jogging, for hiking and mountain climbing, and they never let me down, even in jobs where I haven’t had a chance all day to sit. But my feet simply weren’t designed to fit into early-’80s Italian designer shoes. I encountered the same problem with my slick CIC hearing aids.
My ears apparently were never designed for high-fashion CIC hearing aids. Then, when my hearing levels suddenly dropped off the charts several years ago, it was time to get much more powerful hearing aids, which only came in behind-the-ear (BTE) designs. Even after wearing the CIC hearing aids for several years at that point, I dreaded the look of the BTEs, because I mistakenly felt there was a stigma associated with people who wore them.Work Boots But the minute I put them on, I was in heaven. The soft earmold actually felt good, compared with the hard plastic the CICs had to be made from. And because the tube to the processor provided a healthy distance between microphone and the output from the speaker, feedback was never a problem. The plastic unit that sat on my ear was only about half the size that typical BTE hearing aids had been only several years before. It was big enough to accommodate a telecoil, which opened the wonderful world of assistive listening devices to me. And it had a monstrously powerful digital signal processing (DSP) chip that could be tuned exactly to my hearing levels at all frequencies. I never looked back.
And now, with the dawn of the “open-fit, thin-tube” era, many people can have their cake and eat it, too. Open-fit designs are really sleek BTE hearing aids that have finally struck the right balance of feature, function and fashion. They are the smallest BTEs — the MicroSavia thin-tube product that Phonak just introduced weighs only two grams — so that you have to look hard to even see it hiding behind the wearer’s ear. The clear plastic tube is so thin you need superhuman eyesight to see it. And the “open-fit” earmold is tiny, soft, light, comfortable and completely invisible because it lodges deep inside the ear canal. It’s no wonder the open-fit thin-tube designs are now the fastest-growing segment of the hearing-aid marketplace. I liken them to the Italian shoes since the mid-’90s, when the designers started creating styles that were more rounded, with plenty of room for the toes. They are much more comfortable and practical. Unfortunately, I’m not a candidate for the open-fit thin-tube hearing-aid models, because for severe-to-profound hearing loss you still need so much amplification that feedback can be a problem with the open-earmolds. So I’m looking at the highest-power segment of the BTE market, featuring slightly larger hearing aids. I liken the look of these “power BTEs” to a pair of honest, practical down-to-earth work boots. No shame in wearing them. But even in this category of product there’s hope for fashion. Given the relentless march of digital technology driven by “Moore’s Law” toward more power in ever smaller and less expensive packages, combined with the constant improvements in feedback-cancellation algorithms, I am willing to bet that within two or three years when I’m thinking about yet another upgrade, the thin-tube designs will be within the reach even of people with severe hearing loss like me. But in the meantime, I’ll enjoy the comfort and utility of my power BTEs and just stop worrying about the style.